Future Tech General Health Care Politics

Reputation or Regulation

bureaucratCan Yelp take the place of the Dental Board of Examiners?

Do you pick a contractor or dentist after examining their licenses? No, you consult friends or websites like Yelp to determine the sellers’ reputation. Feedback from customers is more useful than any bureaucrat’s stamp of approval. Internet apps like Lyft’s make this feedback ever better.

via Drive Free – John Stossel – Page 2.

The amazing free and instantaneous exchange of information on the Internet has changed our world in many ways and will continue to do so in ways we cannot yet predict. For example do we need a dental board to license dentists? Would not the instantaneous feedback from users tell the public if a person purporting to be a dentist was in fact qualified? After all Wikipedia has been created almost exclusively with crowd sourced information that is remarkably accurate – except when it isn’t.

I guess I am something of a Libertarian. I do believe that transparency, markets and enlightened self-interest will go a long way to creating a free and prosperous society. On the other hand I also believe that government or society can play a role especially when setting minimum standards.

Yelp reviews can tell you if a dentist is friendly, on time and takes insurance but a user review is useless in evaluating the marginal integrity of a restoration or the cleanliness of a root surface. For that expert evaluation is needed and we have chosen to provide that with state boards and professional licensing. In order to make expert evaluations the board needs experts, that is to say members of the professional or trade group being evaluated.

Sadly what inevitably happens is regulatory capture. The industry being regulated takes over and uses the governing board to limit access and restrict competition. The open, free and instantaneous exchange of information possible with the Internet could alter this. It has already fundamentally changed how we do many things and has the potential to change even more.

For example the gold standard of scientific research has been publication in a peer reviewed journal. This system has great value but like state boards it is susceptible to a type of regulatory capture and even more of a problem; it is agonizingly slow. Future science could come from research freely published online and reviewed immediately by everyone in the field willing to take a look.


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